13-102214 ✓ '! • t
F,lectrical
City of Federal Way Permit #: 13-102214-00-EL
Community&Econ.Dev.Services
33325 8th Ave S
Federal way,WA 98003 Inspection Request Line: (253)835-3050
Ph:(253)835-2607 Fax (253)835-2609 p q
Project Name: CHEVRON
Project Address: 31204 PACIFIC HWY S Parcel Number: 092104 9164
Project Description: Installation of lighted exit sign.
Owner Applicant Contractor
CHEVRON SERVICES CO S M E SOLUTIONS LLC S M E SOLUTIONS LLC
PO BOX 285 2302"A"ST SMESOSL931K1(5/21/13)
HOUSTON TX 77001-0285 TACOMA WA 98402 2302"A"ST
TACOMA WA 98402
Additional Permit Information
Is this an Online or O.T.C.application? Yes Is Use Educational or Institutional? No
Service greater than 999 Amps? No
Electrical Fixtures
Circuits-Commercial 1
PERMIT EXPIRES Saturday, November 16, 2013
Permit Issued on Monday, May 20, 2013
I hereby certify that the above information is correct and that the construction • the above described property and
the occupancy and the use will be in accordance with the laws, rule ..--roi<ulations of the State of Washington
and th ity of =j:e f
Owner or agent: Date: X7e3
41ATHIS CARD IS TO IN ON-SITE
Construction In ection Record
Federal Way INSPECTION REQUE TS: (253)835-3050
PERMIT#: 13-102214-00-EL Address: 31204 PACIFIC HWY S
Project: CHEVRON SERVICES CO FEDERAL WAY, WA 98003
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible(read left to right,top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
El UFER Ground(4295) ❑ Ditch cover(4030) 0 Slab/Concrete Floor(4255)
Approved Approved Approved to place concrete
By Date By Date By Date
El Pool Bonding(4195) El Temporary Power(4275) El Service(4235)
Approved Approved Approved
By Date By Date By Date
o Feeders/Sub-panels(4045) El Rough Electrical(4225) El Ceiling Cover(4020)
Approved Approved Approved
By Date By Date By Date
0 Final-Electrical(4055)
Approved
B Date Z71
0 Rough ElectricalEl Final Electrical Right of Way
Approved Approved0 Approved
By Date By Date By Date
•
EL TRI AL
CITY OF
C C
Federal Way PERMIT APPLICATION
PERMIT NUMBER / 3 _ /V . .2--./ (/, – l../
SITE ADDRESS: ; ig,c.) � 1,144�►�
%,,, 0 SUITEJUNIT/SPACE I
VALUATIONao /6
PROJECT 3/2jAR C �_ �� CURRENT/PROPOSED USE
9 / 6
$
PROJECT NAME " ��
(Tenant or Homeowner Last Name) Li rdY\
-. cif Sr* a_die lavt
PROJECT DESCRIPTION
Detailed description of work to
be included on this permit only
NAME / PRIMARY PHONE
PROPERTY OWNER _.1 t/(/CVl ( 25-3 914 -e6 6'5
MAILING ADDRESS gwy
E-MAIL
3120t/ l� if( S
Cy,... ..i STATE ZIP FAX
�-`zk ( wa y LA,4. 78406)/3 ( ) -
_. - NAME SQ /�'T �CJ�.� 1(C PRIMARY PHONE
St21 ( (253) 672- 5822
MAILING ADDRESS / E-MAIL
ELECTRICAL 2 36 2. 4 S-I-.
CONTRACTOR CITY STATE ZIP FAX
c�.� c ,-v4 � Q2 ( ) -
WA STATE CONTRACTOR'S LICENSE N EXPIRATION DATE FEDERAL WAY BUSINESS LICENSE N
Sr 'o5L?.g1K 1 3' 21 X15
PRIMARY PHONE
APPLICANT �164a...ti �e �d ( ) -
MAILING ADDRESS E-MAIL
2362 4S
CITY STATE ZIP FAX
7�� �- geg62 ( ) -
NAME PRIMARY PHONE
PROJECT CONTACT ,4r L(g i I ( L 5-3) (2a-ice 7
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner.I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct.I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim(including costs,expenses,and attorneys'fees incurred in
the investigation and defense of such claim), which may be made by any person,including the undersigned,and filed against the city,
but only where such claim arises out of the reliance of the city, in • •' g its fficers and employees, upon the accuracy of the
information supplied to the city as a part of this application. `�
- -----1-- 5/',)•/20/3
SIGNATURE• �-— DATE
PRINT NAME: /4`/i 'tA.,✓ Oti_i/ /14I"l
Bulletin#160–January 1,2013 Page 1 of 2 k:\Handouts\Electrical Permit Application